Direct Anterior Approach FAQs

How do I know if I am a candidate for hip replacement? Anterior Approach?

If you have symptoms consistent with those of hip arthritis and your Xrays demonstrate moderate to severe arthritis, then you are a candidate for hip replacement. We would only proceed with surgery however if the benefits of the procedure outweigh your medical risk. The Anterior Approach can be done on all patients for whom hip replacement has been recommended. Patients with very severe arthritis, avascular necrosis, those who are obese, or even those with bilateral hip arthritis are candidates.

Do I have to donate blood before I have anterior total hip replacement?

Dr. Louis does not typically recommend patients to pre-donate blood. During the hip replacement surgery he uses a special Orthopat suction system which allows him to recirculate the patient’s own blood that is lost during surgery & give it back to them.

Will THA help me with my groin pain?

The most common presentation of hip arthritis is patients complaining of groin pain. This is because your hip is actually located deep to your groin (not along the side of your body, as most may think). If you have groin pain & have been diagnosed with hip arthritis confirmed by Xray, then Yes, your groin pain should be relieved after your total hip replacement.

Will my legs be the same length after surgery?

One of Dr. Louis’ goals for his hip patients is to provide them with equal leg lengths after their hip replacement surgery. With the anterior approach, he is able to take Xrays of both hips on a patient intra-operatively and mix & match the trial components on the hip that is being replaced until it creates an equal length & offset to the patient’s other hip. Because of this, Dr. Louis can tell before he completes the surgery that his patient’s legs will be the same length. This is one of the unique advantages to performing total hip replacement from the anterior approach that cannot be done from the more traditional posterior hip replacement.

How long will I be in the hospital?

The typical hospital stay for Dr. Louis’ patients after a hip replacement from the anterior approach is for2 days after surgery. For those patients who have both hips replaced at one time, they may stay one extra day.

Do I have to go to a rehab facility when I am discharged from the hospital?

Some patients who do not have help at home, live in a multi-level house, or have other medical conditions that limit their post-operative progress may opt to go to a rehab facility following their stay at the hospital. The length of stay at a rehab center can vary from a few days to 2 weeks, until the patient is independent and comfortable enough to be on their own.

What is the prosthesis made of?

The prosthesis itself is made of a very strong metal known as Titanium. The bearing surface (or the ball and liner of the new socket) however can be made of several different combinations including ceramic, metal & plastic. The bearing surface is determined by Dr. Louis on an individual basis.

Will I need to take blood thinners after surgery?

Patients who undergo joint replacement surgery are at risk for blood clots for a short time following the surgery. Therefore Dr. Louis’ protocol includes the use of an injectable blood thinner given once a day for 2 weeks after surgery.

How long/soon after surgery will I be able to drive?

If a patient has a left total hip replacement, they can usually drive an automatic car at about 1 week after surgery. If they have a right hip replaced however, Dr. Louis will allow patients to drive at approximately 2-3 weeks after surgery.

For how long will I need to use a walker/cane?

Most healthy patients use a walker for approximately 4 days after surgery and will advance to a cane. Patients are typically able to ambulate without a cane between 2-3 weeks post-operatively.

Will I have any restrictions (or “hip precautions”) after THA from an anterior approach?

Unlike total hip replacement surgery from the posterior approach, the anterior approach allows patients the convenience of being allowed to move their hip in almost any direction possible after surgery without the risk of dislocation. This is because no muscles are cut during the anterior approach to hip replacement and the stability of the hip joint is not compromised.

Will I need to see my regular primary care doctor before having a THA?

Dr. Louis recommends that patients with any medical issues or those over the age of 50 see their primary care physician approximately 3-4 weeks prior to surgery for medical clearance. He wants to make sure that his patients are in their optimal level of wellness before undergoing major surgery & anesthesia.

Is THA from the direct anterior approach the same thing as mini-incision THA?

The terminology regarding total hip replacement surgery can be deceiving. It is important to understand exactly what is meant by a doctors’ description of the approach that he uses since the same terms are often used to refer to very different procedures. “Mini-Incision” can simply refer to the length of the skin incision, but may still involve cutting important muscles surrounding the hip, which is a more important factor in a patient’s recovery. “Minimally Invasive” surgery is also a term used commonly in orthopedics but can have a variety of meanings ranging from the use of a small incision, like “Mini-Incision” to Total Hip Replacement from the Anterior approach that causes less muscle trauma (since all muscles are left intact) in comparison to those done from the Posterior, Lateral, or 2-Incision approaches to hip replacement.

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About Dr. Steven Louis

Dr. Louis is a board certified orthopaedic surgeon and is fellowship trained in the area of trauma. His post-residency training allows him to treat patients with traumatic injury, particularly those with pelvic injuries, complex fractures, non-unions and infections. Additionally, Dr. Louis’ practice focuses on hip and knee replacements.